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Several studies demonstrated biological effects of cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) on human metabolism and central nervous system. Our study investigated the serum levels of tPA along with BDNF and cortisol in children with autism spectrum disorder (ASD). Thirty three male children with ASD ranging in age from 2 to 15 years were selected for the study group and 27 age-matched healthy male children were selected for the control group. The ASD severity was determined by the score on the Autism Behavior Checklist (ABC). The mean cortisol levels for the study group and the control group were 79.1 ± 30.2 ng/ml and 60.0 ± 25.1 ng/ml, respectively. The mean BDNF levels for the study group and the control group were 5.9 ± 2.8 ng/ml and 3.7 ± 1.8 ng/ml, respectively. The mean tPA levels for the study group and the control group were 32.9 ± 18.5 ng/ml and 25.5 ± 15.1 ng/ml, respectively. Cortisol, BDNF and tPA levels were significantly higher in the study group compared to the control group (p 0.001). There was no statistically significant effect in terms of age, ABC total and subscale scores on serum cortisol, BDNF and tPA levels in the study group (p 0.05). It may be suggested that elevations may indicate a role in the pathogenesis of ASD or it may be the case that ASD may alter the levels or pathways of these metabolic factors. LAY SUMMARY: The underlying mechanism or a specific metabolic target relevant to autism spectrum disorder (ASD) has not yet been identified. Cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) have biological effects on neuroplasticity but little is known about the role of cortisol and tPA-BDNF pathway in ASD. In the present study focused on male children with ASD, we have found higher blood levels of cortisol, BDNF and tPA than their healthy peers. This is the first clinical study to evaluate the serum tPA levels along with BDNF and cortisol in ASD. The results suggest that several neurotrophic and other related markers should be born in mind while examining children with ASD.

The inconsistent results about cortisol levels in individuals with autism spectrum disorder (ASD) may be suggestive of other factors like gen polymorphisms rather than the disorder itself. So we aimed to investigate the rs1360780 polymorphism in FK506 binding protein 5 (FKBP5) gene and its relation to ASD and cortisol levels comparing with that of healthy participants. We have included two main groups as study and control groups in the present study. Eighty nine children with ASD ranging in age from 2 to 15 years were selected for the study group and age-matched 86 healthy children were selected for the control group. Cortisol levels were found to be significantly higher in the study group. However there was no statistically significant difference in terms of allele and genotype frequencies between the groups. Carrying the C allele of FKBP5 seems to increase the cortisol levels in the study group. This is the first clinical study to evaluate the association between rs1360780 polymorphism in FKBP5 gene and serum cortisol levels in children with ASD. Since the prevalence of ASD is gradually increasing in recent years, several endocrine and related genetic factors should be born in mind while examining this population.

Introduction Brain-derived neurotropic factor (BDNF) has been suggested to play a role in the pathogenesis of attention-deficit hyperactivity disorder (ADHD). In addition, impairment in executive functions has been reported in children with ADHD. This study investigated the presence of a relationship between Stroop test scores and BDNF levels in children with ADHD. Methods The study was conducted in the Department of Child Psychiatry at Dicle University. The study included 49 children between 6 and 15 years of age (M/F: 42/7), who were diagnosed with ADHD according to DSM-IV, and who did not receive previous therapy. Similar in terms of age and gender to the ADHD group, 40 children were selected in the control group. The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version was administered to all participants. Parents and teachers were administered Turgay DSM-IV-based Child and Adolescent Behavior Disorders Screening and Rating Scale to measure symptom severity in children with ADHD. Children with ADHD underwent the Stroop test. BDNF levels were evaluated in serum by ELISA. Results The ADHD and control groups did not differ in terms of BDNF levels. BDNF levels did not differ between ADHD subtypes. There was also no relationship between the Stroop test interference scores and BDNF levels. Conclusion The findings of the present study are in line with those in studies that demonstrated no significant role of BDNF in the pathogenesis of ADHD.

OBJECTIVE The aim of this study was to investigate whether cortisol and oxidative stress levels and DNA damage differ between individuals who developed PTSD or not following a sexual trauma. METHODS The study included 61 children aged between 5 and 17 years who sustained sexual abuse (M/F: 18/43). The patients were divided into two groups: patients with PTSD and patients without PTSD based, based on the results of a structured psychiatric interview (K-SADS-PL and CAPS-CA). Cortisol, glutathione peroxidase (GPx), superoxide dismutase (SOD), coenzyme Q, 8-Hydroxy-2-Deoxyguanosine (8-OHdG) were all evaluated by the ELISA method. RESULTS Our evaluation revealed a diagnosis of PTSD in 51% (n=31) of victims. There was no significant difference between the groups with or without PTSD in terms of cortisol, GPx, SOD, coenzyme Q, and 8-OHdG levels. There was no correlation between CAPS scores and GPx, SOD, coenzyme Q, and 8-OHdG levels between patients with or without PTSD. In patients with PTSD, both cortisol and 8-OHdG levels decreased with increasing time after trauma, and there was no significant correlation with cortisol and 8-OHdG levels in patients without PTSD. CONCLUSION Although the present study did not find any difference between the groups in terms of 8-OHdG concentrations, the decreases in both cortisol and 8-OHdG levels with increasing time after trauma is considered to indicate a relationship between cortisol and DNA damage.

Neurodegenerative molecules play an important role in maintaining a supply for synaptic vesicles; and they are also likely to help regulate the dopamine release which is the primary mechanism of action in pharmacological treatments for attention deficit hyperactivity disorder (ADHD). It is suggested that there could be interactions between α-synuclein and tau in cytoskeletal disorganization and synaptic dystrophy. Therefore, we aim to determine the serum levels of neurodegenerative molecules such as α-synuclein and tau in children with ADHD. The study group consisted of 25 children, aged 6–10, diagnosed with ADHD according to DSM-IV criteria and who appeared at Dicle University, Faculty of Medicine, and Department of Child Psychiatry in Diyarbakır, Turkey. 25 children, having no psychiatric disorders and medical illnesses, were selected as healthy control group. Serum α-synuclein and tau concentrations were determined by Enzyme-Linked Immuno Sorbent Assay. The α-synuclein levels of ADHD were not significantly different than those of controls. The tau levels of ADHD were found to be statistically significantly higher than those of controls. Moreover, α-synuclein levels showed a statistically significantly positive correlation with tau levels in children with ADHD. The results of our preliminary study can suggest that ADHD might possibly share a common disease mechanism with other diseases in terms of tau pathology. Increased serum tau level may be an indication of disturbance of microtubule transportation in the brains of children with ADHD.

Vitamin D is implicated in several aspects of human physiology, and polymorphisms in the vitamin D receptor gene (VDR) are associated with a variety of neuropsychiatric disorders. The aims of this study are to determine whether VDR polymorphisms are associated with autism spectrum disorder (ASD), to examine serum 25-hydroxyvitamin D (25(OH)D) levels in ASD, and to explore whether VDR polymorphisms influence serum 25(OH)D levels. We investigated 480 subjects (237 children with ASD and 243 healthy controls) for the following VDR polymorphisms: TaqI, BsmI, FokI, ApaI, and Cdx2.Within the same samples, 25(OH)D levels were available only for 85 patients and 82 controls. The Cdx-2 variation was shown to deviate from Hardy-Weinberg equilibrium in the controls and was therefore excluded from the study. We found that the frequency of rare FokI TT, TaqI CC, and BsmI AA genotypes differed significantly between children with ASD and the controls (p=0.042, p=0.016, p=0.038, respectively). After correction for multiple testing, only the TaqI CC genotype remained significant. Further analysis using a recessive model showed that rare genotypes of these polymorphisms were significantly higher in patients compared to controls (p=0.045, p=0.005 and p=0.031, respectively). However, no significant association was found between ApaI and ASD. We found serum 25(OH)D levels to be significantly higher in children with ASD (p0.001) and that the FokI polymorphism had an effect on serum 25(OH)D levels in children with ASD (p=0.041). Additionally, we found the haplotype GTTT (BsmI/TaqI/FokI/ApaI) conferred an increased risk for developing ASD (p=0.022; odds ratio [95% confidence interval]=2.322 [1.105-4.879]). This is the first clinical study evaluating the association between serum 25(OH)D levels and VDR polymorphisms in children with ASD. Our results demonstrated a significant association between TaqI, BsmI, and FokI polymorphisms and ASD and showed for the first time that FokI polymorphisms and haplotype GTTT (BsmI/TaqI/FokI/ApaI) are associated with an increased risk of ASD. Our findings support the hypothesis that 25(OH)D is involved in the pathophysiology of autism and that serum 25(OH)D levels may be affected by FokI polymorphisms in children with ASD. Our results should be considered as preliminary and needs confirmation by future studies.

Objective: The mothers of children diagnosed with atopic dermatitis (AD) may be impacted in many different ways. Aim of the present study was to compare quality of life, anxiety, depression, and alexithymia symptoms between mothers of children diagnosed with AD and mothers of healthy children. Method: The study included 34 mothers of children who were diagnosed with AD between June 2012 and July 2013 and 35 mothers of healthy children. In the study, Short Form 36 (SF-36) Health Survey was used to evaluate quality of life, while the Toronto Alexithymia Scale (TAS) was used to evaluate alexithymia level, the State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety symptoms, and the Beck Depression Scale (BDS) was used to evaluate depression symptoms. Results: There was no statistically significant difference between the mothers of AD patients and control subjects in terms of quality of life, anxiety, depression, and alexithymia. In addition, there was no significant difference in disease severity or symptoms scale scores between the two groups. Conclusion: These results may suggest that mothers’ mental health is not affected in the early stage of the disease. In later stages of the disease, mothers of children with AD may become psychologically affected. Long-term follow up studies are required to clarify this distinction.

Objective: The aim of this study is to investigate oxidative stress and DNA damage among children with attention deficit hyperactivity disorder (ADHD) with or without disruptive behavioral disorders (DBD).

Although the etiopathology of autism spectrum disorder (ASD) is not clear, immune dysfunction has been proposed as a mechanism for the pathophysiology of ASD. The purpose of this study is to examine serum levels of tissue plasminogen activator (t-PA) and some adhesion molecules in children with ASD that have not been investigated previously in detail. The study group included 35 male children aged from 2 to 9 diagnosed with ASD according to DSM-V criteria. Soluble platelet endothelial adhesion molecule-1 (sPECAM-1), P-selectin, E-selectin, and t-PA in the serum were determined with enzyme-linked immunosorbent assay. Autism behavior check list (ABC) is used for the assessment of ASD severity. The levels of t-PA (P = 0.025) and E-selectin (P = 0.007) was detected significantly higher in children with ASD than control group. Serum levels of sPECAM-1 showed statistically significant negative correlation with sensory, body and object-use, language, social, and self-help and total scores in the patient group (r = -0.349, P = 0.04; r = -0.411, P = 0.01; r = -0.412, P = 0.01; r = -0.417, P = 0.01, and r = -0.531, P

The current study aimed to investigate whether serum antioxidant levels and DNA damage differ between the children and adolescents with Obsessive Compulsive Disorder (OCD) and healthy controls. The study included 31 children (Male/Female, 22/9; age range 7-17 years), with treatment naive OCD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) and 28 age- and gender-matched healthy control subjects. Children's Yale Brown Obsession Compulsion Scale (CY-BOC) was applied to the children. Glutathione peroxidase (GPx), superoxide dismutase (SOD), coenzyme Q (CoQ), and 8-Hydroxy-2-Deoxyguanosine (8-OHdG) were all measured by the enzyme-linked immunosorbent assay method. GPx, CoQ and 8-OHdG levels were found to be significantly higher in the OCD group, compared to the control group (p=0.010, p=0.034, p=0.010, respectively); however, no significant difference was found in the SOD levels between two groups (p=0.10). There were no correlations between the CY-BOC scores, depression scores, duration of the disease and biochemical parameters (p > 0.05, for all). Children with OCD were found to have higher antioxidant levels and oxidative DNA damage. The findings of this study support the role of oxidative stress in the pathogenesis of OCD. In this regard, any possible effect of adding antioxidants to conventional treatment can be investigated. (C) 2016 Published by Elsevier Ireland Ltd.

Objective: Oxidative stress has been reported to play a role in the psychopathology of schizophrenia, though only a few studies have investigated the relationship between early-onset schizophrenia and oxidative stress. The aim of the present study is to evaluate the level of oxidative stress and the presence of DNA damage in first-episode psychosis (FEP) in adolescents. Methods: This study was conducted in the Department of Child Psychiatry of the Dicle University Hospital. It included 20 adolescent patients (age 11-17 years) with psychosis (acute psychosis, schizophreniform disorder, or schizophrenia) according to DSM-IV criteria who had received no previous psychiatric therapy (patient group) and 20 age/gender-matched healthy adolescents (control group). Structured psychiatric interviews [Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS-PL) and Positive and Negative Symptom Scale (PANSS)] were conducted on the patients, and the Clinical Global Impressions (CGI) scale was used to evaluate the severity of disease. Glutathione peroxidase (GPx), superoxide dismutase (SOD), coenzyme Q (CoQ), and 8-hydroxy-2-deoxyguanosine (8-OHdG) levels were determined using the ELISA method and commercial ELISA kits. Results: The mean age was 14.5 ± 1.6 years in the FEP group (male-to-female ratio: 8/12) and 14.4 ± 1.5 years in the control group (male-to-female ratio: 8/12). There were no differences between the patient and control groups in terms of SOD, GPx, or 8-OHdG values (p > 0.05). Conclusions: This study on DNA damage and oxidative stress in FEP in adolescents had a small sample size, and our data suggest that oxidative stress is associated with a chronic disease course rather than being an early sign of early-onset schizophrenia.

The aim of this study was to investigate the level of depression and quality of life in children with celiac disease (CD). In addition, it aimed to examine the relations of depression level and life quality with adherence to a gluten-free diet (GFD).Twenty-five children with CD and 25 healthy controls were included. The Depression Scale for Children and the General Purpose Health-Related Quality of Life Scale for Children were performed on patients before and after receiving recommendations to follow a GFD.No significant differences were found in the depression scores between the patients and the control subjects (P 0.05). In contrast, total scores and scores of the emotional well-being subscale of the measure of Quality of Life Scale for Children were significantly lower in patients with CD compared with the control group (P 0.05). No significant improvements were observed in depression or life quality scores of the total subsample of celiac patients, all of whom received a recommendation to follow a GFD (P 0.05). Significant decrease was observed in the depression scores, however, of celiac patients who were able to actually adhere to the GFD compared with nonadherent patients.CD negatively affected quality of life in children. Adherence to GFD was associated with reduction in depression symptoms. Improving the adherence of celiac patients to a GFD may have a favorable effect on their depression symptoms.

OBJECTIVE: There are studies reporting that cortisol and brain-derived neurotropic factor (BDNF) play a role in the pathophysiology of post-traumatic stress disorder (PTSD). However, up-to-date no study evaluated the relationship between PTSD and the levels of cortisol and BDNF in children and adolescents who have sustained trauma. The aim of this study was to investigate whether BDNF, cortisol and adrenocorticotropine (ACTH) levels differ between individuals who developed PTSD or not following a sexual trauma. METHOD: The study included 55 children aged between 6 and 17 years who sustained sexual assault (M/F: 13/42). The patients were divided into two groups, with or without PTSD based on the results of a structured psychiatric interview (K-SADS-PL and CAPS-CA). Of the participants, 49% (n=27) were diagnosed with PTSD. Cortisol, ACTH, and BDNF levels were evaluated using the ELISA method. RESULTS: There were no significant differences between patients with or without PTSD in terms of cortisol, ACTH, BDNF levels. There were no correlations between CAPS-CA scores and cortisol, ACTH, and BDNF levels in patients with or without PTSD. In patients with PTSD, decreased cortisol levels were found with increasing time after trauma, and no significant correlation was found with the cortisol levels in patients without PTSD. CONCLUSION: Although no significant association was found between biochemical parameters and the presence or severity of PTSD; decreasing cortisol levels with increasing time after trauma in patients with PTSD suggest that cortisol might have played a role in the pathophysiology of this disorder. Language: en

Objective: The aim of this study is to compare the sociodemographic and abuse-related data of the children who have presented to the Antalya and Diyarbakir University hospitals due to sexual abuse. Method: The patient files of 172 children between the ages of 4-17 presented to the Akdeniz University, Department of Child and Adolescent Psychiatric Health and Diseases (CAPHD) Clinic within the year 2010, and of 167 children between the ages of 4-17 presented to the Dicle University CAPHD Clinic during the year 2012 were scanned and the sociodemographic and abuse-related data of the patients were recorded. Results: In the Diyarbakir group, the total years of education of the child, the total years of education of the mother, and the total years of education of the father were significantly lower, while the mean number of the siblings was significantly higher. The number of the male abuse survivors in the Diyarbakir group was significantly higher. The family structure where the parents are alive and living together was significantly more frequent in the Diyarbakir group. No difference in terms of the occurrence of penetration and relationship with the abuser was observed between the groups. Conclusion: Within the framework of this study, the characteristics of the survivors of abuse between two socioculturally, economically and ethnically different regions of Turkey (the Mediterranean region and the south-east Anatolian region) have been investigated. This study has demonstrated that some of the sociodemographic and abuse-related characteristics of sexual abuse in Turkey differs between these regions. We are of the opinion that efforts to prevent sexual abuse should be restructured in the light of these results. For instance, prevention of child labour, increasing the literacy rate of the individuals and promoting family planning efforts in south-east Anatolia should be the primary focus of these efforts.

Introductıon:We aimed to determine the serum levels of transactive response of DNAMethods:The study group was composed of thirty children aged between 6 and 10. They were diagnosed with ADHD according to DSM-IV criteria. They were the subjects who applied to Dicle University, Faculty of Medicine, and Department of Child Psychiatry in Diyarbakır, Turkey. Children with ADHD were assessed via Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale and Stroop test. Serum TDP-43 and UCH-L1 levels were analysed with enzyme-linked immunosorbent assay.Results:The TDP-43 and UCH-L1 serum levels of children with ADHD were found to be statistically significantly higher than those of controls. On the other hand, we found that serum levels of TDP-43 correlated with interference effect and hyperactivity–impulsivity in children with ADHD.Conclusıon:Imbalances in serum UCH-L1 and TDP-43 levels, and the correlation of TDP-43 levels with clinical parameters in children with ADHD may suggest that ubiquitin-proteasome pathway alterations are associated with ADHD. Deterioration of this pathway may cause intracellular TDP-43 aggregation.

In this study, it was aimed to understand the underlying possible immunopathogenesis of first episode, early onset schizophrenia (EOS) through profiling the T helper 1 (ThThe study included a total of 30 children, admitted to child psychiatry outpatient clinic aged between 10 and 17 years of age, who had not received prior therapy and were diagnosed with psychosis according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) as the patient group, and 26 age- and gender-matched children as the control group. Structured psychiatric interviews (K-SADS-PL and PANSS) were conducted with all participants. The BD Cytokine Bead Array Human ThThere was no significant difference between groups in terms of IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, and IFN-γ levels (p 0.05). However, there was a significant correlation between IL-10 and IL-4 with negative symptoms of EOS (r = -0.65, p = 0.02 and r = 0.67, p = 0.02, respectively).IL4 and IL-10 levels have a relationship with negative symptoms of disease. Therefore, this study might suggest that immunological processes might have a role in the disease pathophysiology.

Objective In this study, we investigated serum brain-derived neurotrophic factor (BDNF), adrenocorticotropic hormone (ACTH), and cortisol levels between children with obsessive-compulsive disorder (OCD) prior to treatment and healthy controls. In addition, the study aimed to assess any correlations between OCD symptom severity and BDNF, ACTH, and cortisol levels. Methods Twenty-nine children, aged from 7 to 17 years (male/female: 21/8) and diagnosed with OCD according to DSM-IV prior to treatment, were compared with 25 healthy control subjects (male/female: 16/9). The study was conducted between December 2012 and December 2013. The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS-PL), Children's Yale-Brown Obsessive Compulsive Scale, and Children's Depression Inventory (CDI) were administered to the children. BDNF, ACTH, and cortisol levels were detected using a prepared kit with the enzyme-linked immunosorbent assay method. Results BDNF, ACTH, and cortisol levels in the OCD group were significantly higher when compared with the control group (P = .02, P = .03, and P = .046, respectively). No association was detected between the severity and duration of OCD symptoms and BDNF, ACTH, and cortisol levels. CDI scores in both groups were similar. The mean (SD) duration of OCD symptoms was 17.9 (18.5) months. Conclusions Our findings suggest that BDNF levels adaptively increase as a result of the damaging effects of the hypothalamic-pituitary-adrenal (HPA) axis hyperactivity on brain tissue in the early stages of OCD. HPA axis abnormalities and BDNF may play a role in the pathogenesis of the disease.

Amaç: Psikiyatri hastalarındaki fiziksel hastalıklar ihmal edilebilmektedir. Psikiyatri hastalarının ortalama yaşam süresi genel nüfusa göre yaklaşık 25 yıl daha kısadır. Bu somatik semptomlar psikiyatrik hastaların yaşam kalitesini düşürmektedir. Bu çalışmanın amacı psikiyatri hastalarındaki somatik hastalık sıklığını belirlemek ve psikiyatrik tanılar ve klinik özellikler ile somatik tanılar arasındaki ilişkiyi değerlendirmektir.Gereç ve Yöntem: Çalışmamıza 2015 Ocak-Ekim ayları arasında Dicle Üniversitesi Tıp Fakültesi Psikiyatri Kliniği’nde yatan (n=142) hastalar dahil edilmiştir. Bu hastaların dosyaları geriye dönük olarak taranarak değerlendirilmiştir. Hastaların somatik ve psikiyatrik tanıları hastane kayıt sisteminden ve hasta dosyalarından incelenerek belirlenmiştir.Bulgular: Kliniğimize yatan hastaların %51.4’ünün somatik hastalığının olduğu görüldü. Somatik hatalıkların yaş ile arttığı saptandı (p0.05).Sonuç: Çalışmamızda psikiyatrik hastalıklara yüksek oranda somatik hastalıkların eşlik ettiği ve bu somatik hastalıkların daha çok endokrinolojik ve nörolojik hastalıklar olduğu belirlenmiştir. Psikiyatri hastaları toplum tarafından etiketlenmekte, sağlık hizmetlerinden faydalanma olanağı daha düşük olmaktadır. Bu hasta grubunda, somatik hastalık belirtileri açısından daha duyarlı olunmasının morbidite ve mortaliteyi azaltabileceğini düşünmekteyiz.Anahtar kelimeler: Psikiyatrik hastalık, yatan hasta, komorbidite, somatik hastalık.

In this study we aimed to investigate serum cortisol, oxidative stress, and DNA damage in children who are sexual abuse victims. The study included 38 children who sustained child sexual abuse and 38 age- and gender-matched children who did not have a history of trauma. Cortisol levels reflecting the status of the hypothalamic-pituitary-adrenal axis, anti-oxidant enzymes glutathione peroxidase, superoxide dismutase, natural anti-oxidant coenzyme Q, and 8-hydroxy-2-deoxyguanosine as the indicator of DNA damage were analyzed in serum samples using the enzyme linked immunosorbent assay method. Cortisol levels were significantly higher in the child sexual abuse group compared to the control group. There were no significant differences between the groups in terms of oxidative stress and DNA damage. Cortisol and 8-hydroxy-2-deoxyguanosine levels decreased as the time elapsed since the sexual abuse increased. Coenzyme Q level was lower in victims who sustained multiple assaults than in the victims of a single assault. Cortisol and superoxide dismutase levels were lower in the victims of familial sexual abuse. Decreases in cortisol and 8-hydroxy-2-deoxyguanosine levels as time elapsed may be an adaptation to the toxic effects of high cortisol levels over a prolonged period of time. Child sexual abuse did not result in oxidative stress and DNA damage; however, some features of sexual abuse raised the level of oxidative stress.

Objectives: The aim of this study was to investigate prevalence and severity of post-traumatic stress disorder (PTSD) symptoms in sexually abused children and in their parents.Materials and methods: Thirty-six sexually abused children and their parents formed the study group. Among children who presented to a first step health care office with various complaints 54 children without any sexual trauma history and with socio-demographical features similar to the study group have been included in the study with their parents as control group. PTSD symptoms of children and their parents were evaluated by post-traumatic stress disorder scales administered by clinicians.Results: Seventy-five percent of the children in the study group and 25 % of the children in the control group were diagnosed at least one psychiatric disorder. PTSD, depression, and anxiety disorder were the most frequent diagnoses in the study group. Frequency of PTSD diagnosis in children and their fathers was 64% and in their mothers 75%. In the control group it was 2% and 8% respectively.Conclusions: PTSD is prevalent in children victimized by sexual abuse and in their parents. In case of a sexual abuse, evaluating only the children does not seem to be sufficient; rather evaluating also their parents would be beneficial.

Anoreksiya nervoza (AN), kişinin fiziksel bütünlüğünü tehdit edecek şekilde yememe ve kilo vermeye çalışma ile karakterize olan bir yeme bozukluğudur. Anoreksiya nervozada, mortalite riskinin arttığı iyi bilinmektedir. Anoreksiya nervozada ölümler medikal komplikasyonlar ve/veya intihar neticesinde olmaktadır. Bununla beraber, hastalığın seyri boyunca ölüm riskinin zamanlaması belirsizdir. Anoreksiya nervozada mortalite için bazı prediktörler tanımlanmıştır. Bu çalışmada, AN'ya bağlı medikal komplikasyonlar nedeniyle ölen 15 yaşında kız olgunun sunulması planlanmıştır. Anorexia nervosa (AN) is an eating disorder, which is characterized by the avoidance of eating in a way that threatens the physical integrity of an individual, and trying to lose weight. It is known that the risk of mortality is high in AN. Death occurs as a results of medical complications and/or suicide. On the other hand, the exact time point of mortality becoming a risk during the progression of the disease progression is not defined. Certain predictors have been defined for mortality in AN. In this study, our aim was to present a case of a 15-year old female patient, who had died due to medical complications related to AN.

The aim of this study was to investigate serum levels of cortisol and adrenocorticotropic hormone in adolescents with first-episode early onset schizophrenia. A total of 23 adolescent patients, who did not receive prior therapy and who were diagnosed with psychosis according to DSM-IV, were included. Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, Positive and Negative Symptom Scale, and Clinical Global Impression Scale were conducted with the participants. No significant differences were found between the patients and the control subjects in serum cortisol and adrenocorticotropic hormone levels (P .05). Our study's findings do not support the hypothesis of increased hypothalamic-pituitary-adrenal axis activity in first-episode early onset schizophrenia.

OBJECTIVE Brain-derived neurotropic factor (BDNF) is known to play a role in the pathogenesis of schizophrenia. However, the relationship between early onset schizophrenia and BDNF has not been extensively studied. The aim of the study was to compare the levels of BDNF between adolescent patients with first-episode psychosis (FEP) and the healthy control subjects. METHOD The study was conducted in the Department of Child Psychiatry at Dicle University. A total of 26 adolescent patients aged between 11 and 17 years who had not received previous therapy and whose conditions were diagnosed with psychosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and 26 age- and sex-matched healthy adolescent control subjects were included. Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version, and the Positive and Negative Symptom Scale were conducted with all participants. The clinical global impression was used to evaluate disease severity. The BDNF levels were measured in the serum by enzyme-linked immunosorbent assay method. RESULTS The mean (SD) age was 14.6 (1.6) years in both FEP group (male/female, 11/15) and the control group (P > 0.05). The FEP group had significantly lower serum BDNF levels (2.0 ± 1.9 ng/mL) compared with the control group (3.4 ± 3.0 ng/mL, P = 0.03). There was no significant relationship between BDNF concentration and the Positive and Negative Symptom Scale (positive and negative scores) scores (r = -0.14, P = 0.74 and r = 0.49, P = 0.22, respectively). There was no significant relationship between the duration of untreated psychosis and serum BDNF levels (r = -0.22, P = 0.32). CONCLUSIONS High incidence of schizophrenia in patients with FEP suggests a relationship between BDNF levels and the pathogenesis of schizophrenia. We suggest that BDNF may be a useful neurobiological marker of early onset schizophrenia.

Objective Sexual abuse continues to be a major problem in the world. In our country the numbers of these types of studies are increasing in recent years. In this study our aim is to review literature which concerns with sociodemographic characteristics of sexual abuse victims and types of sexual abuse. Methods The studies on sexual abuse conducted within the last 10 years in Turkey were scanned using the, GirişCinsel istismar, tüm dünyada önemli birsorun olmaya devam etmektedir. Ülkemizde de sonyıllarda bu konu ile ilgili yapılan çalışmaların sayısıartmaktadır. Bu çalışmada; Türkiye’nin farklıbölgelerinde cinsel istismar mağdurları üzerindeyapılmış olan, olguların sosyodemografik veistismara ait özelliklerini içeren araştırmayazılarının gözden geçirilmesi ve güncel bilgilerinortaya konması amaçlanmıştır.YöntemTürkiye’de son 10 yılda, cinsel istismarüzerine yapılmış çalışmalar ‘istismar’, ‘cinselistismar’ anahtar kelimeleri ile Pubmed, GoogleAkademik, Scoopmed, Türk Psikiyatri Dizini,Türkiye Atıf Dizini ve Medline arama motorlarıkullanılarak taranmıştır. Çalışmamıza polikliniğebaşvuran adli olguların dökümünü yapan 20çalışma alınmıştır.BulgularÇalışmaların geneline baktığımızdaolguların %50’den fazlası 12-18 yaş aralığındaydı.Ülkemizdeki çalışmalarda kız/erkek oranı en düşük1,3, en yüksek 6,6idi. Parçalanmış aile oranıtoplum ortalamasına göre daha yüksekti. Cinselistismar mağdurları istismarın türü yönündenincelendiğinde penetrasyona (oral, anal, vaginal)maruziyet oranı oldukça yüksek olduğugözlemlenmiştir. İstismarcıya olan yakınlıkaçısından değerlendirildiğinde batı ülkelerinebenzer oranlar saptanmıştır.SonuçBu çalışmalarda genel olarak kayıtlarınyetersiz tutulduğu saptanmıştır. Aynı zamandakullanılan tanımlamalarda da farklılıklar olduğugözlenmiştir. Ülkemizde 3 yaş altı mağdurolmaması ve batı ülkelerine görepenetrasyonamaruziyet oranının yüksek olmasıdikkat çekmiştir. Bu gözden geçirme çalışmasındanelde edilen bilgiler ışığında bazı önerilerinyapılması uygun görülmüştür.Anahtar kelimeler: istismar, cinsel istismar, kötümuamele, kurban, adli vaka, Türkiye

Objective: In this study, we aimed to investigate whether a relationship between the presence and severity of trauma symptoms and duration/frequency of abuse and socio-demographic variables exist or not. Methods: Sixty-five children, aged between 5-17 years, who were admitted to Child and Adolescent Psychiatry Department of Akdeniz University Hospital due to sexual abuse have been enrolled to the study with their mothers. Existing psychopathologies of children were evaluated by Kiddie Schedule for Affective Disorders and Schizophrenia-Lifetime version (K-SADS-PL) and PTSD were evaluated by Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA). For identifying PTSD in their parents Clinician Administered PTSD Scale (CAPS) was used. Results: 84.6% of victims (n = 55) were female and15.4% (n = 10) were male. There was no significant relationship between the frequency and duration of abuse and CAPS B, C, and D scores (P> 0.05). Similarly, no significant relationship was present between the frequency and duration of abuse and CAPS B, C, and D scores of the mothers (P> 0.05). In females, age and education level were positively correlated with the CAPS B, C and D scores. Parents' education level was tending to be lower by decreasing age of victimized children. Conclusion: Multiple factors (personal, familial, and pertaining to abuse) may play role in the impact of abuse on mental health of survivors of sexual abuse. Education levels of parents seem to be related with both the abuse risk of children and its impact on the child\'s mental health after sexual abuse., Amaç: Bu çalışmada istismar süresi, istismar sıklığı ve diğer sosyodemografik değişkenler ile travma belirtilerinin varlığı ve şiddeti arasında ilişkinin olup olmadığını araştırmayı amaçladık. Yöntemler: 2010 yılında Akdeniz Üniversitesi ÇERSH polikliniğine cinsel istismar nedeniyle başvuran 5-17 yaşları arasındaki 65 çocuk ve 65 anne değerlendirmeye alındı. Çocukların DSM IV\'e göre tanısının ve eş tanıların belirlenmesi için Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi Şimdi ve Yaşam Boyu Versiyonu (K-SADS-PL) uygulanmasının ardından Travma Sonrası Stres Bozukluğu (TSSB) varlığının ve şiddetinin belirlenmesi için çocuk ve gençler için klinisyen tarafından uygulanan travma sonrası stres bozukluğu ölçeği” (TSSB-ÖÇE) uygulandı. Annelerde TSSB varlığının ve şiddetinin belirlenmesi için ise klinisyen tarafından uygulanan travma sonrası stres bozukluğu ölçeği” (TSSB-Ö)uygulandı. Bulgular: Mağdurların %84,6\'sı (n=55) kız, %15,4\'ü (n=10) ise erkekti. Hem istismar süresi hem de istismar sıklığı ile CAPS (TSSB-ÖÇE) B, C ve D puanları arasında anlamlı bir ilişki saptanmadı (P>0,05). Benzer şekilde istismar süresi ve istismar sıklığı ile annenin CAPS (TSSB-Ö) B, C ve D puanları arasında da anlamlı bir ilişki yoktu (P>0,05). Kızlarda, yaşın ve eğitim yılının CAPS (TSSB-ÖÇE) B, C ve D puanları ile pozitif korelasyonu vardı. İstismar yaşı düştükçe anne ve babanın eğitim yılı da düşüş göstermekteydi. Sonuçlar: Cinsel istismar sonrası ruhsal etkilenmede çoklu etmenlerin (bireysel, ailesel ve istismara ait) birlikte rol oynadığını düşünmekteyiz. Ebeveynlerin eğitim düzeyi hem istismar riski hem de çocukta istismar sonrası görülen ruhsal etkilenme ile ilişkili olabilir.

Objective: In the present study, to assess the sexual assault victims considering sociodemographic and forensic psychiatry who were examined by our Board of Physical and Mental Health was aimed. Methods: The cases who were examined in Board of Physical and Mental Health in Forensic medicine Department of Dicle University, Faculty of Medicine were assessed retrospectively in terms of age, gender, marital status, education level, relation of the victim with the accused, presence of penetration and disruption of physical and mental health. Results: Among 258 cases, who referred to our board, 196 were female and 62 were male. The age range of the victims was 2 to 50 and average age was detected as 13.1 ± 5.9 years. It was determined that 227 (88%) cases were under 18 years and 31 cases (12%) were above 18 years. Vaginal and anal penetration was claimed in 48 and 61 cases, respectively; oral + anal penetration was claimed in 11 cases; both vaginal and oral penetration was claimed in two cases. Among 258 cases, 144 cases had no physical and mental disruption; 49 cases were diagnosed with mental and physical health disruption and 65 cases were followed by issuing a preliminary report. Conclusion: As a result of our study any significant relation is not found between impairment in psychological health and sex, marital status, educational level of the victim, age groups, the age difference between the victim and the defendant. Therefore, it is understood that either men or women, married or single, educated or uneducated people are affected emotionally as bad as from sexual assault. This supports the idea that, especially in cases that any findings cannot be obtained with genital and physical examination, psychological evaluation may be important., Amaç: Bu çalışmada Beden ve Ruh Sağlığı Heyetimizce muayenesi yapılan cinsel saldırı mağdurların sosyodemografik ve adli psikiyatri yönünden değerlendirilmesi amaçlanmaktadır. Yöntemler: Dicle Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı Beden ve Ruh Sağlığı Heyetinde 2012-2014 yılları arasında muayene edilen olgular; yaş, cinsiyet, medeni durum, öğrenim durumu, mağdurun sanık ile ilişkisi, penetrasyon olup olmaması ve beden ruh sağlıklarının bozulup bozulmadığı yönünden retrospektif olarak değerlendirildi. Bulgular: Heyetimize başvuran 258 olgunun 196 tanesi kadın olup 62 tanesi erkekti. Maruz kalınan yaş aralığı 2 ila 50 yaş aralığında olup yaş ortalamalarının ise 13,1 ± 5,9 yıl olduğu saptanmıştır. Olguların 227'sinin (%88) 18 yaş ve altında olduğu, 31'nin (%12) 18 yaşından büyük olduğu belirlenmiştir. 48'inde vajinal, 61'inde anal penetrasyon, 11\'inde oral, 11\'inde oral+ anal penetrasyon, 2 vakada ise hem vajinal hem de oral penetrasyon iddiası vardı. Başvuran 258 vakadan 144 tanesinde ruh ve beden sağlığı bozulmadığı, 49 vakada ruh ve beden sağlığı bozulduğu tanısı konulmuş olup 65 vaka ise ön rapor verilerek takibe alınmıştır. Sonuç: Çalışmamız sonucunda ruh sağlığında bozulma ile cinsiyet, medeni durum, mağdurun eğitim durumu, yaş grubu ve sanık ile mağdur arasındaki yaş farkı arasında anlamlı bir ilişki bulunamamıştır. Dolayısıyla ruhsal açıdan cinsel saldırıdan erkeklerin kadınlar kadar, evlilerin bekarlar kadar, eğitimlilerin eğitimsizler kadar kötü etkilendiği anlaşılmıştır. Bunun yayında özellikle genital ve fizik muayene ile bulgu elde edilemeyen olgularda ruhsal değerlendirmenin de önemli olduğu açığa çıkmıştır.

Background Previous reports have suggested the biological and psychological effects of trauma induced by cortisol and brain-derived neurotrophic factor (BDNF). The present study compared the levels of BDNF, cortisol, and adrenocorticotropic hormone (ACTH) in children and adolescent victims of sexual abuse to those without a trauma history. Methods The study was conducted in the Department of Child Psychiatry at Dicle University. The study included 44 children (M/F: 12/32) aged between 8 and 17 years who experienced sexual abuse with 42 age-and gender-matched children who did not have a history of trauma. Cortisol, ACTH, and BDNF levels were measured using ELISA. Results Cortisol levels were higher and BDNF levels were significantly lower in the victims of sexual abuse compared to the control group. The mean time that elapsed from the initial sexual abuse occurrence until the date of examination was 22.7 ± 21.7 months. The evaluation of the relationship between this time span and cortisol levels revealed that cortisol levels decreased with increasing time after trauma. Cortisol and BDNF levels were lower in the victims who experienced multiple sexual assaults. Conclusions The results of the present study suggest that cortisol and BDNF could be biological molecular mediators of the effects of trauma on biological and psychological systems. This is the first report on the effects of cortisol and BDNF induced trauma in child and adolescent victims of sexual abuse.

The aim of this study was to investigate serum levels of cortisol and adrenocorticotropic hormone in adolescents with first-episode early onset schizophrenia. A total of 23 adolescent patients, who did not receive prior therapy and who were diagnosed with psychosis according to DSM-IV, were included. Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, Positive and Negative Symptom Scale, and Clinical Global Impression Scale were conducted with the participants. No significant differences were found between the patients and the control subjects in serum cortisol and adrenocorticotropic hormone levels (P > .05). Our study's findings do not support the hypothesis of increased hypothalamic-pituitary-adrenal axis activity in first-episode early onset schizophrenia.

Background: Previous reports have described an association between autoimmunity and primary obsessive compulsive disorder. This study aimed to investigate any differences in the levels of T helper 1, 2, and 17 effector cell cytokines between obsessive compulsive disorder patients and the control group. Methods: The study included 34 children (23 males, 11 females), aged between 7 and 17 years, with a diagnosis of obsessive compulsive disorder prior to receiving treatment. The control group consisted of age- and gender-matched children. Study participants were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version, Children’s Yale Brown Obsession Compulsion Scale, and Children’s Depression Inventory. Cytokine serum concentrations were measured using the BD Cytometric Bead Array Human Th1/Th2/Th17 Cytokine Kit. Results: Interleukin-17A, tumor necrosis factor-α, and interleukin-2 levels were significantly higher in obsessive compulsive disorder patients, However, there was no correlation between T helper 1 and 17 cytokine profiles in the obsessive compulsive disorder group. The duration and severity of obsessive compulsive disorder symptoms were not significantly associated with interleukin-17A, interferon-gamma-γ, interleukin-10, interleukin-6, interleukin-4, and interleukin-2 levels. Interestingly, a negative correlation was found between tumor necrosis factor-α levels and Clinical Global Impression scores. Conclusions: These findings suggest, in some cases, obsessive compulsive disorder may develop on a background of autoimmunity, and interleukin-2, tumor necrosis factor-α, and interleukin-17A may play a role in these autoimmune processes. Therefore, we believe it is important to investigate for obsessive compulsive disorder symptoms in patients with autoimmune disease and, conversely, autoimmune diseases in obsessive compulsive disorder patients.

Attention Deficit Hyperactivity Disorder (ADHD) and other psychiatric symptoms in parents of children with ADHD Objective: The aim of this study is to investigate Attention Deficit Hyperactivity Disorder (ADHD) and other psychiatric symptoms of the parents of children with ADHD. Method: Mothers (n=34) and fathers (n=29) of 34 children with ADHD were included into the study group. Mothers (n=34) and fathers (n=31) of 34 children with no history of referral to a doctor due to previous psychological problems and for whom diagnoses of ADHD and Disruptive Behavior Disorder (DBD) according to DSM-IV were ruled out were assigned as the controls. The parents were given Symptom Check List (SCL-90-R) and Adult Attention Deficit Hyperactivity Scale (ADHD-A). Results: Parents from the patient group were found to have significantly more ADHD and psychiatric symptoms compared to parents from the control group. Conclusion: In the evaluation and treatment process of children with ADHD, it would be beneficial to monitor their parents in terms of adult ADHD and related co-morbid psychiatric conditions. It is suggested that treating parents would benefit in the improvement of ADHD symptoms in children.